As far as the eye can see: Bucknell researchers look to improve vision in Guatemala

July 30, 2012

LEWISBURG, Pa. — The road to the motel in San Pedro, Guatemala, was narrow and steep — about 5 feet wider than the bus — and descending on a 20-degree incline, as Associate Professor of Mechanical Engineering Charles Kim recalls it.

The bus driver had mastered the hairpin turns on the mountain roads between Guatemala City and the lakeside village of San Pedro. But the last stretch of the 3 1/2-hour trip seemed a formidable final obstacle, especially in the pouring rain — with no guardrails.

Still, the passengers had little idea that day in August 2011 of what challenges the bus driver had overcome to get them to their destination. They would find out later that he had done so without the benefit of eyeglasses and with significant vision impairment.

The bus driver is among many in Guatemala who do not have proper vision care both because of expense and the scarce availability of optometry services. Kim and Associate Professor of Management Jamie Hendry, along with a number of student researchers, are working to change that. They are developing tools and a sustainable business plan to diagnose vision deficiencies and manufacture and distribute eyeglasses in remote villages.

The project was initiated by Bucknell alumnus Adam Andersen, a 2010 graduate in mechanical engineering and management who completed his master's in mechanical engineering in 2012. He recruited Kim and Hendry to help after reading Paul Polak's book, Out of Poverty, in which the author asserts that uncorrected vision is a crippling factor in overcoming poverty. Other groups have pursued the idea, but cost, distribution, local involvement, and sustainability are continuing challenges.

The right fitAs part of the project, Kim and mechanical engineering students Tyler Campbell, Greg Epremian, and Andy Klein perfected a design for a diagnostic tool, which they jokingly dubbed the "pirate telescope." It is made with two pieces of PVC piping that slide into one another and enables anyone to diagnose vision deficiencies within .5 diopter, the common measure used by optometrists, Kim said. Kim and his students also previously designed a lens edger, which includes a grinding wheel and round template lens — much like a key cutter — to enable a local entrepreneur to make eyeglasses for about $5 rather than the standard $300 to $400.

During the 2011 trip, the Bucknell group traveled with a cohort from Christ Wesleyan Church in Milton, including Lewisburg optometrist Robert Lipski. Lipski examined dozens of children and adults, including the bus driver. In most cases, the optometrist found that even those who wore eyeglasses had the wrong prescription. The Bucknell and Christ Wesleyan group took several suitcases full of donated eyeglasses to Guatemala in the hope of matching villagers with their proper prescriptions, Kim said, but that method proved a bit like finding a needle in a haystack.

"Bob examined the bus driver, and he couldn't see anything," Kim recalled. "Bob searched in his suitcase full of donated glasses and fortunately was able to find a pair with the right prescription."

Style countsThe project has taken some unexpected turns, in part after the revelation that children even in remote parts of Guatemala are concerned about style.

"During our trip in 2011, Andy, Adam and I designed a lens cutter but found we could not cut oblong shapes," Kim said. "We simplified the machine so it could cut circular-shaped lenses, and it worked well. But we found that no one wanted to wear circular-shaped lenses."

The group also realized they needed to involve the community and get buy-in for the effort, rather than trying to determine what was best for the villagers, Hendry said.

"If we are going to create a sustainable business, it is essential that this is a local organization," Hendry said. "Local folks need to get involved in designing and eventually running the business. And once it's up and running, we go away, and they handle it on their own."

Sustainable businessHendry, meanwhile, has been working with management students to determine appropriate business models. The management group is considering a model comprising three workers: one to diagnose and fit the eyeglasses; one to cut lenses and assemble them with frames: and one to manage the office, inventory, maintenance and supplier relations.

A continuing challenge is the cost of transportation.

"Most of the optometry services are in Guatemala City," Hendry said. "Just the expense of traveling is prohibitive for most people. The town where we would like to set up the business is on a lake. There are little villages all around the lake, but if you need to get to one side or the other, it costs a week's wages."

One idea for reducing transportation costs is to travel with local churches and schools to offer optometric services periodically in remote areas, Hendry said.

Pursuing partnerships This winter, Kim and Hendry plan to travel to Guatemala again with students. The management students will be researching legal issues and surveying optometry students about their interest in serving in rural areas. The Bucknell group also will pursue partnerships with suppliers and other churches and schools and search for space for a warehouse and workshop. The engineering students will continue to work on creating optometric devices that can be constructed using locally available materials and local labor and equipment and that will produce eyewear that is both functional and aesthetically pleasing.

Over time, the group hopes to increase the sustainability of the operation. The team will investigate, for example, whether scraps produced from lens cutting may be reused or recycled and whether frames can be manufactured locally.

Despite the challenges, Hendry said, the project is rewarding. She recalled delivering a new pair of glasses to a girl at an elementary school during a trip in March. Lipski, the Lewisburg optometrist, had examined the girl's eyes the previous August and discovered the glasses she had were the wrong prescription. So he made new glasses for her and sent them back to Guatemala with the Bucknell team.

"This girl was wearing a pair of glasses with a cord around her neck. She tried on the new pair of glasses and found she could see so much more, so she ripped off the older pair. That really brought it home for me, how important it is for these people to get the eye care they really need."

Hendry and Kim eventually hope to expand the project by replicating it in other locations in the developing world, such as Nicaragua, they said.

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